Job Summary:
Completes medical coding by reviewing relevant medical records to identify elements to be abstracted, as well as diagnostic and procedure codes, and assigning appropriate codes for diagnoses, procedures, and other services rendered, following coding guidelines for the most current version of the International Classification of Diseases Clinical Modification (ICD-CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Level II for patient encounters. Assists with documentation and coding compliance by following applicable federal, state, and local laws and regulations, The Principles of Responsibility, the Code of Conduct for Kaiser Permanente, internal policies and procedures, professional standards, and accreditation standards. Supports efforts to update coding processes and meet regulatory goals by helping assure the accuracy of current procedures and diagnosis codes upon request from various sources.
Essential Responsibilities: - Pursues effective relationships with others by sharing information with coworkers and members. Listens to and addresses performance feedback. Pursues self-development; acknowledges strengths and weaknesses, and takes action. Adapts to and learns from change, challenges, and feedback. Responds to the needs of others to support a business outcome.
- Completes routine work assignments by following procedures and policies and using data, and resources with oversight and management. Collaborates with others to address business problems; escalates issues or risks as appropriate; communicates progress and information. Adheres to established priorities, deadlines, and expectations. Identifies and speaks up for improvement opportunities.
- Assists with documentation and coding compliance by: learning and following applicable federal, state, and local laws and regulations, The Principles of Responsibility, the Code of Conduct for Kaiser Permanente, internal policies and procedures, professional standards, and accreditation standards.
- Supports efforts to update coding processes and meet regulatory goals by: learning to perform analysis/review to assure the accuracy of current procedures and diagnosis codes upon request from various sources; using internal resources (e.g., webinars, enterprise education team) to learn up-to-date knowledge of standards and regulatory requirements related to coding, documentation, and management compliance (federal, state, internal), and researching guidance for individual coding situations as necessary, with guidance; and meeting and maintaining department standards for productivity and quality.
- Completes medical coding by: assigning appropriate codes for diagnoses, procedures, and other services rendered, following coding guidelines for the most current version of the International Classification of Diseases Clinical Modification (ICD-CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Level II for patient encounters with oversight; using detailed instructions to identify and assign appropriate codes for diagnoses, procedures, and other services rendered; assisting team members with identifying coding issues through partnership with clinicians, department administration, and other coding staff based on review, coding guidelines, and queries or issues with practitioner-submitted medical codes to reduce denials and improve time to submission; and providing basic support to team members who provide consultation to staff and care providers on all coding and documentation questions.